Classification of perinatal deaths according to ICD-PM: an audit on perinatal post-mortems in a tertiary care centre in Sri Lanka

Priyani, A. A. H.; Thuvarakan, P.; Silva, M. V. C. De

doi:10.4038/sljog.v39i2.7811

Cited by 10 publications

(20 citation statements)

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“…Well-designed prospective studies are urgently needed to identify high-risk women and develop effective stillbirth prevention strategies. A gradually shifting pattern is seen globally, from high SBRs with mostly intrapartum deaths in low-income countries to low SBRs with mostly antepartum deaths in high-income countries [10,[25][26][27][28][29] (see appendix file 2). The SBR and timing of stillbirth can be incorporated into the 'obstetric transition' framework, which describes five stages in which countries shift from high maternal mortality and fertility and many communicable diseases (stage I-II) to low maternal mortality and fertility and more non-communicable diseases [30].…”

Section: Discussionmentioning

confidence: 99%

“…In middle-income countries, the proportion of antepartum (80%) and intrapartum (20%) stillbirths suggests that intrapartum quality of care is gradually improving and antenatal quality of care improvement is essential for further reduction of perinatal mortality [10,28,29]. Suriname follows these trends with 85% of stillbirths in the antepartum period and serves as an example of a country, which has largely overcome barriers for women to access care.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have reported a wide variation in the distribution of causes, even between countries with similar settings and economies [ 10 , 25 – 29 ]. While we classified placental abruption as antepartum hypoxia, similar to the ICD-PM pilot study in the United Kingdom and South Africa (2016) [ 10 ], a later study in South Africa (2018) classified placental abruption as ‘Other specified antepartum disorders (A4)’ [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

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Investigation of stillbirth causes in Suriname: application of the WHO ICD-PM tool to national-level hospital data

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Bhikha-Kori

et al. 2020

Global Health Action

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Background: Suriname has one of the highest stillbirth rates in Latin America and the Caribbean. To facilitate data comparison of perinatal deaths, the World Health Organization developed the International Classification of Diseases-10 Perinatal Mortality (ICD-PM). Objective: We aimed to (1) assess characteristics and risk indicators of women with a stillbirth, (2) determine the timing and causes of stillbirths according to the ICD-PM with critical evaluation of its application and (3) propose recommendations for the reduction of stillbirths in Suriname. Methods: A hospital-based, nationwide , cross-sectional study was conducted in all hospitals within Suriname during one-year (2017). The medical files of stillbirths (gestation ≥28 weeks/ birth weight ≥1000 grams) were reviewed and classified using ICD-PM. We used descriptive statistics and multiple logistic regression analyses. Results: The stillbirth rate in Suriname was 14.4/1000 births (n=131 stillbirths, n=9089 total births). Medical files were available for 86% (n=113/131) of stillbirths. Women of African descent had the highest stillbirth rate and two times the odds of stillbirth (OR 2.1, 95%CI 1.4-3.1) compared to women of other ethnicities. One third (33%, n=37/113) of stillbirths occurred after hospital admission. The timing was antepartum in 85% (n=96/113), intrapartum in 11% (n=12/113) and unknown in 4% (n=5/113). Antepartum stillbirths were caused by hypoxia in 46% (n=44/96). In 41% (n=39/96) the cause was unspecified. Maternal medical and surgical conditions were present in 50% (n=57/113), mostly hypertensive disorders. Conclusion: Stillbirth reduction strategies in Suriname call for targeting ethnic disparities, improving antenatal services, implementing perinatal death audits and improving diagnostic post-mortem investigations. ICD-PM limited the formulation of recommendations due to many stillbirths of 'unspecified' causes. Based on our study findings, we also recommend addressing some challenges with applying the ICD-PM.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Investigation of stillbirth causes in Suriname: application of the WHO ICD-PM tool to national-level hospital data

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Bhikha-Kori

et al. 2020

Global Health Action

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“…En una revisión realizada en las bases de datos Medline vía PubMed, Embase y Web of Science, con los términos "ICD Perinatal Mortality"; "ICD-PM"; "International Classification of Disease and Perinatal" and "Mortality and Perinatal", solo se encontraron cinco artículos con investigación primaria de su utilización. Dos artículos hacen parte del proceso inicial de construcción y validación del sistema (16,17), otro fue realizado por integrantes de los equipos que hicieron la validación inicial para evaluar la compatibilidad del nuevo sistema con otro de utilización previa (18), y dos fueron realizados por grupos independientes, uno con 75 muertes en Zambia (19) y otro con 291 muertes en Sri Lanka (20), para caracterizar la mortalidad hospitalaria.…”

Section: Discussionunclassified

Aplicación del Sistema de Clasificación Internacional de Enfermedades para la Mortalidad Perinatal CIE-MP a partir de registros vitales para clasificar las muertes perinatales en Antioquia, Colombia

Salazar-Barrientos

Tobón

2019

Rev. Colomb. Obstet. Ginecol.

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Objetivo: describir la mortalidad perinatal del departamento de Antioquia según la Clasificación Internacional de Enfermedades CIE-MP de la Organización Mundial de la Salud (OMS) y evaluar la factibilidad de aplicar el sistema de clasificación a partir los registros vitales oficiales. Materiales y métodos: estudio descriptivo de las causas de muerte perinatal según el momento del fallecimiento con respecto al parto y las condiciones maternas asociadas. La fuente primaria fue la base de datos oficial de estadísticas vitales entre los años 2013 y 2016. Se midieron: la edad materna, la edad gestacional, el peso al momento del parto, el área de residencia, el tipo de parto, las causas de muerte (directas, asociadas) y otros estados patológicos. Se hace análisis descriptivo, se presenta el número absoluto y el porcentaje de las causas distribuidas según el momento de ocurrencia de la muerte con respecto al parto y el peso al nacer. Resultados: de 3901 muertes perinatales ocurridas en fetos con 22 semanas o más, o mínimo 500 g de peso y hasta los 28 días de vida, 1404 (36,0 %) se presentaron antes del parto, 378 (9,7 %) en el intraparto, 1760 (45,1 %) en el periodo neonatal y 359 (9,2 %) casos no contaban con información del momento del fallecimiento con relación al parto. Las principales causas de muerte de los recién nacidos de 1000 o más g fueron las malformaciones congénitas, las deformidades y las anormalidades cromosómicas (30,2 %); la hipoxia anteparto e intraparto (29,3 %) y la infección (12,3 %). En el 69,5 % no se identificaron causas maternas asociadas, y en las identificadas, la más frecuente fue la complicación de placenta, cordón y membranas (16,8 %). Conclusión: el CIE-MP es un sistema de clasificación aplicable globalmente a partir de los registros vitales, que permitió caracterizar la mortalidad perinatal del departamento.

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“…The emerging published studies have demonstrated that ICD-PM can be easily applied to already existing perinatal mortality data collection systems in low-and middle-income countries. 8,9,13 It is important that applications in high-income countries also occur to support the widespread adoption across all settings. ICD-PM presents an opportunity to capitalise on an existing global classification system that links maternal complications to perinatal deaths and, with some modifications, could present a standardised, accurate and globally acceptable system of classification.…”

mentioning

confidence: 99%

Why correctly identifying maternal condition in perinatal death classification systems is crucial: a commentary

Lavin

Preen

Allanson

et al. 2020

BJOG

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Classification of perinatal deaths according to ICD-PM: an audit on perinatal post-mortems in a tertiary care centre in Sri Lanka

Cited by 10 publications

References 5 publications

Investigation of stillbirth causes in Suriname: application of the WHO ICD-PM tool to national-level hospital data

Investigation of stillbirth causes in Suriname: application of the WHO ICD-PM tool to national-level hospital data

Aplicación del Sistema de Clasificación Internacional de Enfermedades para la Mortalidad Perinatal CIE-MP a partir de registros vitales para clasificar las muertes perinatales en Antioquia, Colombia

Why correctly identifying maternal condition in perinatal death classification systems is crucial: a commentary

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